‘Crystal meth’ use among polydrug users in Sydney's dance party subculture: characteristics, use patterns and associated harms
Introduction
Amphetamines remain Australia's second most widely used illicit drug after cannabis (Australian Institute of Health and Welfare, 2002). Australia's markets for illicit amphetamines have undergone considerable change in recent years (Topp, Degenhardt, Kaye & Darke, 2002). Traditionally, the form of illicit amphetamine most available was amphetamine sulphate (Chesher, 1993). Following the legislative controls introduced in the early 1990s on the distribution of the main precursor chemicals (Wardlaw, 1993), the pseudoephedrine-to-methamphetamine conversion became the most widely used, and methamphetamine currently dominates the market (Australian Bureau of Criminal Intelligence, 2002).
Chemically, amphetamine and methamphetamine are closely related. Both exert their effects indirectly by stimulating the release of peripheral and central monoamines (principally dopamine, noradrenaline, adrenaline and serotonin) (Seiden, Sobol & Ricaurte, 1993), and both have psychomotor, cardiovascular, anorexogenic and hyperthermic properties. Compared with amphetamine, methamphetamine has proportionally greater central stimulatory effects than peripheral circulatory actions (Chesher, 1993), and is a more potent form with stronger subjective effects. In countries such as Japan, Taiwan, the Phillipines, the Republic of Korea and the United States (US), methamphetamine has been the form of amphetamine most available in recent years, and has been of concern as its availability and use have spread, and associated problems have become more clearly delineated (Farrell, Marsden, Ali & Ling, 2002, Methamphetamine Interagency Task Force, 2000, Shaw, 1999, United Nations Office of Drug Control Policy, 2000).
Australia's strategic early warning system for emergent trends in illicit drug markets, the Illicit Drug Reporting System (IDRS) (Hando, Darke, O'Brien, Maher & Hall, 1998, Topp & McKetin, in press), has documented recent increases in the availability and use of potent forms of methamphetamine. The IDRS findings suggest that there are at least four forms of methamphetamine considered as distinct commodities (Topp et al., 2002). These are: (1) ‘speed’, or methamphetamine powder that is locally manufactured, generally of low purity, and is usually administered by snorting or injecting; (2)‘pills’, which are locally manufactured methamphetamine tablets, often mixed with other drugs such as ketamine, that are sold as ‘ecstasy’; (3) ‘base’ or ‘paste’, which is a gluggy, pasty or oily kind of methamphetamine powder that is locally manufactured and often has a brown or yellow tinge due to the presence of iodine and other organic impurities; and (4) ‘crystal meth’ or ‘ice’, which is high purity, imported crystalline methamphetamine that comes in the form of large, translucent to white crystals that are usually smoked or injected.
This paper focuses on ‘crystal meth’ and its use among polydrug users in Sydney's dance party subculture. The staple drug in the party circuit remains ‘ecstasy’, but polydrug use is the norm among this population (Topp, Hando, Dillon & Solowij, 1999), and the use of crystal meth has increased in recent years (Topp & Darke, 2001; Topp et al., 2002). International experience suggests that crystal meth use is associated with significant harm, most notably psychiatric problems such as methamphetamine-induced psychosis (Farrell et al., 2002; Matsumoto et al., 2002, Yui, Goto, Ikemoto, Nishijima, Yoshina & Ishiguro, 2001), but also physical, relationship, occupational, financial and legal issues (Joe-Laidler & Morgan, 1997, Morgan & Beck, 1997, Pennell, Ellett, Rienick & Grimes, 1999). For some, crystal meth use is closely associated with sexual activity (Morgan & Beck, 1997), and high-risk sexual activity in particular (Semple, Patterson & Grant, 2002).
To investigate the apparent increase in the availability and use of crystal meth in Sydney's party drug markets, a sample of 45 participants recruited for a study of GHB use and overdose (Degenhardt, Darke & Dillon, 2002a, Degenhardt, Darke & Dillon, 2002b) who reported the use of ‘crystal meth’ were administered a brief questionnaire regarding their experience with the drug. Although the external validity of the results obtained from this sample of crystal meth users may be constrained, these data constitute a timely and preliminary investigation of use of crystal meth, and provide the first Australian evidence for the notion that crystalline methamphetamine may be associated with higher levels of harm than amphetamine sulphate.
The aims of this preliminary investigation of crystal meth use were to examine:
- 1
The characteristics and drug use patterns of a sample of self-reported crystal meth users;
- 2
The context and the perceived benefits and costs of crystal meth use;
- 3
The psychological and physical side effects perceived by respondents as associated with their crystal meth use; and;
- 4
The similarities and differences of this profile of side effects with those reported by a sample of amphetamine sulphate users recruited in the early 1990s, with the hypothesis that, due to the greater potency of crystal meth, these users may experience a relatively greater degree of harm than users of amphetamine sulphate.
Section snippets
Sample of crystal methamphetamine users
A sample of 76 participants were interviewed (by the first author) for a study of GHB use and associated harms between January and June 2001 (Degenhardt et al., 2002a; Degenhardt et al., 2002b). These participants were volunteers who were paid AU$30 for their participation. They were recruited from advertisements in local newspapers, snowballing, radio interviews, internet bulletin boards, and the AIDS Council of NSW. The sole entry criterion was use of GHB in the preceding 6 months.
Of this
Demographic characteristics of crystal meth users
Eighty two percent of the participants were male, with a mean age of 28.3 years (S.D. 6.5; range 19–45). They had completed a median of 13 years (range 10–13) of school education, and most (82%) had completed further qualifications. Significant proportions of this sample identified as homosexual (58%) or bisexual (16%). The majority (85%) was currently employed, and 4% were students. One participant (2%) had a history of incarceration, and one (2%) was currently in methadone maintenance
Discussion
The data from this sample of self-identified ‘crystal meth’ users provide Australia's first specific investigation of the use and associated harms of this potent form of methamphetamine, the availability and use of which have increased markedly in recent years (Topp et al., 2002).
Acknowledgements
This research was funded by the AIDS Council of New South Wales and the National Drug and Alcohol Research Centre. Thanks to Evelyn Wilhelm, who assisted with data scoring and entry; and to Shane Darke, who provided valuable comments on the manuscript.
References (34)
- et al.
Levels and correlates of polydrug use among heroin users and regular amphetamine users
Drug and Alcohol Dependence
(1995) - et al.
Polydrug dependence and psychiatric comorbidity among heroin injectors
Drug and Alcohol Dependence
(1997) - et al.
GHB use among Australians: characteristics, use patterns, and associated harm
Drug and Alcohol Dependence
(2002) - et al.
Amphetamine-related harms and treatment preferences of regular amphetamine users in Sydney, Australia
Drug and Alcohol Dependence
(1997) - et al.
Motivations associated with methamphetamine use among HIV+ men who have sex with men
Journal of Substance Abuse Treatment
(2002) - et al.
Ecstasy use in Australia: patterns of use and associated harm
Drug and Alcohol Dependence
(1999) - et al.
Adverse effects of stimulant drugs in a community sample of drug users
Drug and Alcohol Dependence
(1997) - et al.
Susceptibility to subsequent episodes of spontaneous recurrence of methamphetamine psychosis
Drug and Alcohol Dependence
(2001) - et al.
The methamphetamine-HIV connection in Northern California
- Australian Bureau of Criminal Intelligence (2002). Australian Illicit Drug Report, 2000–2001. Canberra: Commonwealth of...
Pharmacology of the sympathomimetic psychostimulants
Transitions between routes of administration of regular amphetamine users
Addiction
Methamphetamine: drug use and psychoses becomes a major public health issue in the Asia Pacific region
Addiction
Route of administration and adverse effects of amphetamine use among young adults in Sydney, Australia
Drug and Alcohol Review
Cited by (72)
Methamphetamine-induced profound rhabdomyolysis and myoglobin cast nephropathy: A case report and a literature review
2023, Journal of Forensic and Legal MedicineMethamphetamine, amphetamine, and aggression in humans: A systematic review of drug administration studies
2022, Neuroscience and Biobehavioral ReviewsCitation Excerpt :These high consumption rates have attracted widespread attention for their perceived role in violence and other aggressive behaviours (Hayley et al., 2019). In questionnaires about positive and negative experiences following use of crystal methamphetamine, stimulant users have indicated aggression as one of “the worst things about using crystal meth[amphetamine]”, and list violent behaviour as a self-reported side effect perceived as related to crystal methamphetamine use (Degenhardt and Topp, 2003). It is not clear, however, whether stimulant use per se, or co-occurring social, economic, environmental, or systemic factors drive this anecdotal relationship reported by some users (e.g., personality, alcohol use, psychiatric status).
Methamphetamine-related postmortem cases in Jeddah, Saudi Arabia
2021, Forensic Science InternationalCitation Excerpt :The mean percentage reached 35% (range: 3–333%) in Kalasinsky et al. [60]. In the current study, the median amphetamine/methamphetamine percentage was 55%, higher than most previously reported cases, which can be explained by the high probability of methamphetamine being mixed with amphetamine during synthesis or both drugs were used [16,35]. Amphetamine is commonly detected in Saudi Arabian drug users, but it is less available in other countries [5].
Trends and characteristics of extra-medical use of quetiapine among people who regularly inject drugs in Australia, 2011–2018
2021, Drug and Alcohol DependenceCitation Excerpt :Indeed, a study of 25 people who reported extra-medical quetiapine use found that the main reason for use was to “recover” from the negative effects of other substances [26]. While it was not specified which particular drugs quetiapine was being used to ‘recover from’, other studies have shown that benzodiazepines are often used to help come down from stimulants (Degenhardt and Topp, 2003); the sedative effects of quetiapine suggest that it could be being used for a similar purpose. Regardless of motivation, these findings highlight the need for targeted harm reduction interventions among this group, which are focused on the risks associated with combining stimulants and sedatives.
Mental health in non-heterosexuals: Minority stress theory and related explanation frameworks review
2017, Mental Health and PreventionCitation Excerpt :Some studies also demonstrated that gays and bisexual males may be ‘early adopters’ of new drug trends (Measham, Wood, Dargan, & Moore, 2011), making them specifically important for substance use monitoring (Lea et al., 2013). Examples of these ‘early adoptions’ are documented patterns of gamma-hydroxybutyrate (GHB) or methamphetamine use in Australia (Degenhardt & Topp, 2003; Degenhardt, Darke, & Dillon, 2002). A more detailed look at these studies shows that these results on GHB or methamphetamine relate also to other ‘club drugs’ such as, ecstasy, cocaine, ketamine, or lysergic acid diethylamide (LSD) (Lea et al., 2013).
Trends in cannabis-related ambulance presentations from 2000 to 2013 in Melbourne, Australia
2015, Drug and Alcohol Dependence